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bd2999 

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Member Since: Sat May 17, 2008


During my reading of some medical/scientific journals I came across the following in the New England Journal of Medicine. One of the most prestigious medical journals in the world. The following is a perspective piece from members of the American Board of Internal Medicine.

https://www.nejm.org/doi/full/10.1056/NEJMp2204813?query=TOC&ssotoken=U2FsdGVkX18vtK2%2BXhskrcocjNnhE%2F4%2FUqhGmeo8roxJsy8%2FBocIqGkEVS9texwSPsx%2BtEhawB65pnscWpYKzI7POS9m4clXlX7ml2J%2F1hgRlTd4xT9JRH%2BX856QUUU%2FqVRV9phgEBZChdhkDmHEe7DQHzn7UTJgQgCim5bp9A7e4NmYJBKrsI%2B8ApnKqbOFRwT1ZKw6cbi9PK5y46RRDA%3D%3D&cid=NEJM+eToc%2C+May+19%2C+2022+DM1056939_NEJM_Non_Subscriber&bid=983852849

I hope that works, it is titled "Physicians Spreading Misinformation on Social Media — Do Right and Wrong Answers Still Exist in Medicine?"

Some of the issues discussed are not new but it brings up issues as to what responsibility professional organizations have in enforcing medical standards.

For instance, during COVID, some folks with MDs have basically spread misinformation on social media. Driving the campaign that has led to numerous unneeded deaths throughout the pandemic. Such speech can be somewhat governed but it is not illegal, compared to commercial fraud activities on the platforms. Even though this false information can lead to death (COVID or other vaccine preventable illnesses).

The article specifically discusses board certification bodies threatening to discipline those that are found to do this (through a process of hearings and appeals to allow everybody to be heard). For those not in the know you do not need board certification to practice medicine technically, but if you do not have it than it is iffy on finding a job or actually practicing medicine. The process requires that physicians stay up to date on the standards of care and practice evidence-based medicine and they are tested at varying frequency and must take so many accredited courses a year. Or rather a total number of credits from taking those classes.

It also brings up a disturbing trend, to me anyway, this professional policing would be done to help ensure doctors are giving information to protect patients and not just spewing nonsense with no basis in fact. And it would not be that rapid. However, some states like Tenn (and others apparently) have passed laws preventing these boards from punishing basically any treatment of COVID.

So a doctor could say take bleach or whatever and the professional bodies could do nothing. In that example one would hope the state medical board or law enforcement would be involved, but they pretty much cut off the certification bodies from doing anything.

That seems an abuse in disguise of protecting the right to descent. In science the outside point of view is valuable and in something poorly understood various ideas should be considered, but too many pseudoscience types will not change and will always rely on the "science has been wrong before" or "Galleleo gambit" of the lone truth teller. They generally have no real evidence for their perspectives or opinions.

Which to me makes it a no brainer that these sorts of people should be punished if they are telling lies that impact people's lives and have no evidence to back up their claims in any systematic way.

There may have once been an argument from desperation or right to try but there are things that can be done now with varying effectiveness. And while I am less clear on the current right to try law, classically the doctor had to have some basis for thinking it would benefit their patient. Many of the studies used to promote things like ivomectin and similar have been demonstrated to be so factually wrong and misleading that they can no longer be used as any sort of basis for anything at all.

In some ways how the culture war has bled into medicine and science even moreso than normal.







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The Avenger


Location: New Jersey
Member Since: Thu Dec 02, 2021


At a minimum, a physician who recommends something patently ridiculous like drinking bleach should lose his or her license to practice medicine and should face the possibility of lawsuits for malpractice.



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bd2999 

Moderator

Member Since: Sat May 17, 2008


It can be rough at times. I had big issues the other day with it.

I would agree with you the bleach aspect is an extreme example that would be an easy outlier. I included it because based on the summary provided in the article the person could not lose certification for such things.

Seems, at least in terms of professional advice on medical matters, physicians should be guided by the standard of care unless it is a very unusual case and even then they should be guided by as much research as possible on a subject matter.

Taking shots in the dark is not good.

Although some of those folks will point to studies that were not peer reviewed, not well done and so on. Those sorts of studies when they are found to be flawed should not be included in decision making anymore, but they tend to linger and are held up as folks getting silenced.




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The Avenger


Location: New Jersey
Member Since: Thu Dec 02, 2021


It should go without saying, but I'll say it:

Medical practitioners should be swayed by nothing but science, the wisdom of their own experience, the biological particulars of the patient, and the Hippocratic Oath. If a practitioner can be shown, with evidence, to have been swayed by politics or religion in any way, to even the remotest extent, then he or she should lose the license to practice medicine and face the possibility of lawsuits for malpractice. Zero tolerance for politics or religion in the doctor's office!

And by the way, here we have an instance where an omnipotent, unassailable Supreme Court is likely to rule in a way we don't like, and base it on the words, "prohibiting the free exercise thereof." Textualism would unfortunately support their conclusion, but originalism probably wouldn't, because it's highly doubtful the Framers had any intention of letting the bible dictate medical procedure. Still, an amendment would be best.

The Medical Practice Amendment

Neither religious scripture, doctrines, or decrees, nor political manifestos, policies, or pronouncements, shall be permitted by Congress to legally justify medical practices out of step with the best science of the day.




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bd2999 

Moderator

Member Since: Sat May 17, 2008



    Quote:
    It should go without saying, but I'll say it:



    Quote:
    Medical practitioners should be swayed by nothing but science, the wisdom of their own experience, the biological particulars of the patient, and the Hippocratic Oath. If a practitioner can be shown, with evidence, to have been swayed by politics or religion in any way, to even the remotest extent, then he or she should lose the license to practice medicine and face the possibility of lawsuits for malpractice. Zero tolerance for politics or religion in the doctor's office!


I agree, although I think punishment should be based on severity. If it led to something minor than the punishment should be moreso, but leading to severe outcomes should be harshly punished.


    Quote:
    And by the way, here we have an instance where an omnipotent, unassailable Supreme Court is likely to rule in a way we don't like, and base it on the words, "prohibiting the free exercise thereof." Textualism would unfortunately support their conclusion, but originalism probably wouldn't, because it's highly doubtful the Framers had any intention of letting the bible dictate medical procedure. Still, an amendment would be best.


It honestly depends on what the majority wants to lean to on that day. Honestly, the limitations put on the First Amendment alone should be enough but since those are not specifically in there it is potentially at risk.

I think legally the other challenge is directly proving harm came from a comment. It likely did, but it is hard to prove for anything really. And it is where practioners of nuttiness reside.


    Quote:
    The Medical Practice Amendment



    Quote:
    Neither religious scripture, doctrines, or decrees, nor political manifestos, policies, or pronouncements, shall be permitted by Congress to legally justify medical practices out of step with the best science of the day.



I do not see a direct problem with it. I do think it should be a violation of the hypocratic oath anyway.

Medical Boards already do a cruddy job of policing their own, partly because of strict state regulation. Seems like alot of these folks are causing harm with no benefit and should be in line to lose their license at best and get in more trouble than that at worst.






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